The History of AV Nodal Reentry

Scheinman, Melvin M.; Yang, Yanfei

doi:10.1111/j.1540-8159.2005.50241.x

Cited by 29 publications

(7 citation statements)

References 48 publications

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“…AVNRT can be typical (also referred to as the common form) or atypical (the uncommon form) depending on the location of the atrial deflection between consecutive QRS complexes. This is thought to reflect direction of reentrant excitation with the AV nodal circuit [36]. …”

Section: Ecg Manifestations Of Dual Av Nodal Pathways Physiologymentioning

confidence: 99%

Dual Atrioventricular Nodal Pathways Physiology: A Review of Relevant Anatomy, Electrophysiology, and Electrocardiographic Manifestations

Mani

Pavri

2014

Indian Pacing and Electrophysiology Journal

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More than half a century has passed since the concept of dual atrioventricular (AV) nodal pathways physiology was conceived. Dual AV nodal pathways have been shown to be responsible for many clinical arrhythmia syndromes, most notably AV nodal reentrant tachycardia. Although there has been a considerable amount of research on this topic, the subject of dual AV nodal pathways physiology remains heavily debated and discussed. Despite advances in understanding arrhythmia mechanisms and the widespread use of invasive electrophysiologic studies, there is still disagreement on the anatomy and physiology of the AV node that is the basis of discontinuous antegrade AV conduction. The purpose of this paper is to review the concept of dual AV nodal pathways physiology and its varied electrocardiographic manifestations.

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Section: Ecg Manifestations Of Dual Av Nodal Pathways Physiologymentioning

confidence: 99%

Dual Atrioventricular Nodal Pathways Physiology: A Review of Relevant Anatomy, Electrophysiology, and Electrocardiographic Manifestations

Mani

Pavri

2014

Indian Pacing and Electrophysiology Journal

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“…Our knowledge of the electrophysiological mechanisms underlying AVNRT has remained generally unchanged for many years 2,3 and the exact anatomical correlates of the mechanism remain a mystery 4 . Persistence of slow pathway conduction after ablation has been well‐documented after successful elimination of tachycardia 5–9 .…”

Section: Discussionmentioning

confidence: 99%

One Slow Pathway or Two?

Mohamed¹,

Gula²,

Skanes³

et al. 2006

Cardiovasc electrophysiol

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CaseA 56-year-old man with a history of palpitations and documented narrow complex tachycardia was referred to our center for assessment. There was no history of heart disease and left ventricular function was normal.Electrophysiology study and ablation were performed using standard methods with the patient in the postabsortive state and under conscious sedation. Catheters were positioned in the high right atrium, right ventricular apex, coronary sinus, and His position. Baseline intervals were AH 72 msec, This manuscript was processed by a guest editor. Figure 1. AV node reentrant tachycardia initiated by atrial extrastimulus testing at drive cycle length 400 msec and coupling interval 270 msec.HV 41 msec, and QRS duration 75 msec. Atrial extrastimulus testing demonstrated a rate-dependent increase in conduction time over the AV node without a discrete "jump" to a slow AV nodal pathway. Tachycardia was initiated at drive cycle length 400 msec and coupling interval 270 msec (Fig. 1). The rhythm was AV node reentrant tachycardia (AVNRT) as determined by diagnostic pacing maneuvers. Tachycardia was reliably induced at coupling intervals 240-270 msec, and single echoes were observed at coupling intervals less than 240 msec. Slow pathway ablation was performed and extrastimulus testing was repeated. Tachycardia was no longer inducible, but single AV nodal echoes were still observed at coupling intervals less than 270 msec. AV node conduction curves before and after ablation are demonstrated in Figure 2. What do these curves suggest regarding AV node conduction properties and the impact of ablation? DiscussionInitial atrial extrastimulus testing demonstrated that conduction over the slow AV nodal pathway resulted in typical

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“…If tachycardia could not be induced, an infusion of isoproterenol was started and pacing protocols were repeated. The diagnosis of AVNRT was established according to the accepted criteria 13,14 …”

Section: Methodsmentioning

confidence: 99%